I need some TRT advice, guys...

I've been to the Cleveland Clinic and ALMOST got a prescription for TRT. My testosterone ranged between 135 and 177. My hypogonadism is central (either hypothalamus or pituitary). I'm not getting the go-ahead unless I get a prostate biopsy, however.

I won't do the biopsy because I'm not risking incontinence or impotence at 37 years of age - especially when my PSA score ranges from 1.1 to 0.9.. In May, my PSA shot up to 7.8. Something went wrong with the lab work - I could tell by the way the doctor was telling me they needed to run the test a couple of times. Some other factors had me completely convinced the test was a fluke. 6 weeks later, I tested again at 1.1.. Two weeks after that, 0.9...

If I had any cancer growing in my prostate, the PSA score would not simply go back to normal - cancer doesn't just go away. Plus, I had absolutely no symptoms of BPH. I was fine. The test was wrong and I refuse to get a biopsy and take risks for no reason.

I'll continue my testosterone therapy on my own. If my PSA goes up again, I'll cross that bridge if and when I come to it. At any rate, I'll get my testosterone cypionate from my HRT doctor as always..

Now here's where I need the help.. Before I stopped TRT in May, I felt great. I had a tremendous libido. I wanted to screw every woman walking around me. My wife probably wouldn't like to know that, but I'm sure she'd rather have me too horny than not horny at all. Everything was great. I was taking about 500mg of Cypionate per week.

Why so much? Because I thought the subcutaneous method wouldn't work so well. Plus, I was taking HCG - which eventually boosted my testosterone score to 1500 (with high DHT and Estrogen as well). So, yes - it was working far better than I thought it would.

The problem is - toward the end, I started losing that super high libido.. From doing lots of reading and asking questions, I come to the conclusion that as my Estrogen went up with the addition of HCG toward the end, my libido went down...

I want to do a NORMAL cycle of TRT. I'm not looking to get huge or strong - I just want to have my libido back. It's important to me. And not only that, I felt really great about life.. Everything was coming together so nicely.

Would anyone like to give me some advice on how much to take? I'm guessing I'll start out with 200mg of Cypionate per week (daily injections) with 250iu of HCG every 5 or 6 days. I think every 4 days or so is too much. I noticed my testes shrink a LOT toward the end - before I came off of everything because of that crazy PSA score. For the month before I stopped, I used the HCG and my testes were back to normal. I think I can easily get away with using less HCG to get similar results. Even if the results aren't as perfect - I'll be fine..

If anyone can give me an idea where to start - what to take to fight the Estrogen buildup that caused my libido to go down - I'd really, really appreciate it. I have my own ideas but I'd love to hear what some of you guys think..

Sorry to hear about your situation, I'm not in any way qualified to give anyone adivce and I'm new to TRT myself, but my personal experience was the first thing my Dr. prescribed was arimidex and had me on it for 6 weeks before he even decided to prescribe HCG and Test, he wanted to see where my numbers where with the estrogen blocker by itself to assess HCG/Test treatment

Sorry to hear about your situation, I'm not in any way qualified to give anyone adivce and I'm new to TRT myself, but my personal experience was the first thing my Dr. prescribed was arimidex and had me on it for 6 weeks before he even decided to prescribe HCG and Test, he wanted to see where my numbers where with the estrogen blocker by itself to assess HCG/Test treatment

With such a large jump in PSA I would figure it being a lab error as well, but if it was consistant for 2-3 test then either you had a sex fest 48 hours prior or further investigation needs to be done. Your dr is being proactive so be thankful for that. EStrogen not DHT is usually culprit in PSA.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

Thanks, guys.. As for the PSA stuff - yeah, my Estrogen was very high due to the large amount of testosterone that I was taking along with HCG - but I have a hard time believing it went up that high, that fast and came down to a very low score all so quickly. Besides, the next two tests were exactly what I'm used to seeing - between 0.9 and 1.1... The results were likely skewed - and it could possibly have something to do with 4 hours sex with no climax the day before (long story)...

Sorry to hear about your situation, I'm not in any way qualified to give anyone adivce and I'm new to TRT myself, but my personal experience was the first thing my Dr. prescribed was arimidex and had me on it for 6 weeks before he even decided to prescribe HCG and Test, he wanted to see where my numbers where with the estrogen blocker by itself to assess HCG/Test treatment

With such a large jump in PSA I would figure it being a lab error as well, but if it was consistant for 2-3 test then either you had a sex fest 48 hours prior or further investigation needs to be done. Your dr is being proactive so be thankful for that. EStrogen not DHT is usually culprit in PSA.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

TRT cycles for hypogonadism doesn't make any sense. If you need T because your body doesn't make enough for whatever reason, then you need some form of hormone replacement involving either T, HCG only, or both - for life.

I want to do a NORMAL cycle of TRT. I'm not looking to get huge or strong - I just want to have my libido back. It's important to me. And not only that, I felt really great about life.. Everything was coming together so nicely.

Would anyone like to give me some advice on how much to take? I'm guessing I'll start out with 200mg of Cypionate per week (daily injections) with 250iu of HCG every 5 or 6 days. I think every 4 days or so is too much. I noticed my testes shrink a LOT toward the end - before I came off of everything because of that crazy PSA score. For the month before I stopped, I used the HCG and my testes were back to normal. I think I can easily get away with using less HCG to get similar results. Even if the results aren't as perfect - I'll be fine..

If anyone can give me an idea where to start - what to take to fight the Estrogen buildup that caused my libido to go down - I'd really, really appreciate it. I have my own ideas but I'd love to hear what some of you guys think..

Thanks in advance...

Endocrinologists typically prescribe 200mg of Test-E or Cyp IM bi-weekly for primary hypogonadism (balls don't function). Secondary is usually 150-200mg bi-weekly after tweaking. Few endos actually prescribe weekly injections, but from what I have seen, it's only 100mg/week. I've seen 200mg/bi-weekly in a secondary drive E2 above the normal range (in the beginning), but later tests showed E2 go back to normal range. Since you were used to a higher dose before, 200mg/week may be good for you. Not sure where that will put your freeT & TT doing it SC. That dose shot IM will put your Test past the top of the normal range, and I would think it'd do the same to E2.

Endocrinologists typically prescribe 200mg of Test-E or Cyp IM bi-weekly for primary hypogonadism (balls don't function). Secondary is usually 150-200mg bi-weekly after tweaking. Few endos actually prescribe weekly injections, but from what I have seen, it's only 100mg/week. I've seen 200mg/bi-weekly in a secondary drive E2 above the normal range (in the beginning), but later tests showed E2 go back to normal range. Since you were used to a higher dose before, 200mg/week may be good for you. Not sure where that will put your freeT & TT doing it SC. That dose shot IM will put your Test past the top of the normal range, and I would think it'd do the same to E2.

Where are you getting this Bull crap from because none of it is true. 200 mgs BI weekly thats a light steroid cycle. If the Dr knows what they are doing then 100-120 mgs is usually dosage with adex and hcg added in layered.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

Where are you getting this Bull crap from because none of it is true. 200 mgs BI weekly thats a light steroid cycle. If the Dr knows what they are doing then 100-120 mgs is usually dosage with adex and hcg added in layered.

First off, show some respect to other members of this board, and do not address me in that manner again. If you disagree, there are more civilized ways to do it.

I'm getting this from research and experience. 200mg/bi-weekly is hardly a "steroid cycle." 200mg/week is a light steroid cycle. Are you saying 100-120mgs weekly or bi-weekly? 120mgs bi-weekly will hardly do anything for some that are clinically hypogonadal (nothing for primaries). May help sub-clinical hypo patients. Depending on the state you live and/or whether you are primary or secondary, many docs won't even incorporate testosterone+hCG. It's one or the other. Many don't prescribe aromatase inhibitors, either. They lower the testosterone dosage. (Though I do agree with what you are saying about "if the Dr. knows what they are doing." Unfortunately, this practice hasn't been adopted by the American Association of Clinical Endocrinologists).

I've had bloodwork for 200mg/bi-weekly of test-E measured at 1 week after injection and 5 weeks after starting therapy come back under 500 ng/dL, and this is in a secondary patient. Hardly a steroid cycle...

Are lower doses used in some patients? Of course. I've also read of patients prescribed 250mg/bi-weekly. Every patient should be treated as an individual as metabolisms and other factors will vary.

17.2% body fat at the moment and going down fairly quickly... I was at 30% in January...

Originally Posted by Philec48

TRT cycles for hypogonadism doesn't make any sense. If you need T because your body doesn't make enough for whatever reason, then you need some form of hormone replacement involving either T, HCG only, or both - for life.

I only mentioned "cycle" because I had stopped after my incorrect high PSA score. It was a bad choice of words...

Originally Posted by Mass_69

Endocrinologists typically prescribe 200mg of Test-E or Cyp IM bi-weekly for primary hypogonadism (balls don't function). Secondary is usually 150-200mg bi-weekly after tweaking. Few endos actually prescribe weekly injections, but from what I have seen, it's only 100mg/week. I've seen 200mg/bi-weekly in a secondary drive E2 above the normal range (in the beginning), but later tests showed E2 go back to normal range. Since you were used to a higher dose before, 200mg/week may be good for you. Not sure where that will put your freeT & TT doing it SC. That dose shot IM will put your Test past the top of the normal range, and I would think it'd do the same to E2.

I was in the 500 (testosterone) range taking things like Long Jack and Horny Goat Weed.. That didn't do anything for my libido, however.. Doesn't the normal "natural" range go up between 900 and 1100? If so, than I don't see why I shouldn't aim that high.. I'll have to experiment and see how I feel in certain ranges.. I just want the libido back to the way it was.. I have a feeling that I can stay lower in the range with the right Estrogen blocker...

Originally Posted by tribaltek

If you're in Ohio... take the trip to see Dr. John Crisler in Lansing, MI.

I was in the 500 (testosterone) range taking things like Long Jack and Horny Goat Weed.. That didn't do anything for my libido, however.. Doesn't the normal "natural" range go up between 900 and 1100? If so, than I don't see why I shouldn't aim that high.. I'll have to experiment and see how I feel in certain ranges.. I just want the libido back to the way it was.. I have a feeling that I can stay lower in the range with the right Estrogen blocker...

I've seen "natural" testing ranges from 250-1100 ng/dL, it depends on the testing assay used by the lab. I think you may be right with watching the estrogen levels. There is a "sweet-spot" for most men, which varies between them of course. There are many other factors to consider if monitoring e2 does not improve things for you, including thyroid, adrenals, basically any other endocrine system.

Originally Posted by EasyEJL

I think the matrix is confusing the term bi-weekly (once every 2 weeks) with semi-weekly (2x a week). Important distinction, a lot of people in non-accounting related make that mistake.

Good call. Folks in the non-clinical field could make that mistake too, as it's terminology for prescribing/dosing.

I've seen "natural" testing ranges from 250-1100 ng/dL, it depends on the testing assay used by the lab. I think you may be right with watching the estrogen levels. There is a "sweet-spot" for most men, which varies between them of course. There are many other factors to consider if monitoring e2 does not improve things for you, including thyroid, adrenals, basically any other endocrine system.

Good call. Folks in the non-clinical field could make that mistake too, as it's terminology for prescribing/dosing.

"natural" testing ranges from 250-1100 ng/dL, is right for general population.

Problem is that this metric (TT-TotalTestosterone) is a very misleading when used for individual.

Individual responds to
BAT-BioAvailableTestosterone.

Then it gets clouded again.

Many labs jumped at the BAT bandwagon.

From my experience only Quest Diagnostics came close,
AND
only on one of their tests.
They have more tests that are not as good.